Cardiology

Coronary Angiogram Treatment

Angiography

A coronary angiogram is a special x-ray of your heart. The purpose of this x-ray is to look for abnormalities of your heart muscle or heart valves, and to see if your coronary arteries are narrowed or blocked. Another term for coronary angiogram is cardiac catheterisation.

What is Coronary angiogram?

A coronary angiogram is a type of special x-ray of your heart. The purpose of this x-ray is to check for abnormalities of your heart muscles or heart valves, and to examine if your 
coronary arteries are narrowed or blocked. It's done to find out if coronary arteries are blocked or narrowed, and if, where and by how much. Coronary angiograms are part of a 
general group of procedures known as cardiac catheterizations. Cardiac catheterization procedures can both diagnose as well as treat heart and blood vessel conditions.  A well known  
term for coronary angiogram is cardiac catheterisation. The test is done in a special laboratory called a cardiac catheterisation laboratory, which is similar to an 
operating theatre. A slender catheter which is a thin and hollow plastic tube is threaded through the largest artery in your body, until it reaches the coronary arteries of the 
heart. A special contrast dye is injected and then x-rays are taken of the blood vessels as the dye moves through them.Page Image

Why Coronary angiogram is done?

Your doctor may recommend that you should have a coronary angiogram if you have:
• Symptoms of coronary artery disease, like chest pain.
• Pain in your jaw, neck or arm that can't be explained by other tests.
• New or a increasing chest pain.
• A heart defect, you were born with.
• Abnormal results on a non-invasive heart stress test.
• Other blood vessel problems or chest injury.
• Heart valve problem that requires surgery.

Because there's a small risk of complications, angiograms aren't usually done until non-invasive heart tests have been performed, such as an electrocardiogram, an 
echocardiogram or a stress test.

What problems can be diagnosed by coronary angiogram?

The heart receives the blood supply from coronary arteries. If these arteries are narrowed or blocked, the heart starves from sufficient oxygen and nutrients. The resulting 
pain is also known as angina. Apart from diseased coronary arteries, an angiogram can also diagnose range of heart problems including aneurysm, heart arrhythmias (irregular heart 
beat) or birth defects, such as a hole in the heart.

What does this operation involve?

You may get admitted to hospital the day before your angiogram. You are showered using a special antiseptic soap to reduce the risk of infection. A small area of your body is 
shaved. Once in the cath lab, you are lied on a special table. A heart monitor records your heart beat during this test. The doctor injects small amount of local 
anaesthetic around the test site to numb the area and then inserts a small catheter through the skin into the blood vessel. The doctor watches the progress of the catheter via x-rays 
transmitted at a television monitor. You can't feel the catheter going through heart because there are not enough nerves in the blood vessels. Once the catheter is at place, a 
small amount of x-ray sensitive dye is injected via it. Further the x-rays are taken as the dye goes through the blood vessels. You may feel a warm flush as the dye is 
injected. The angiogram lasts for around forty minutes.

Is a coronary angiogram painful?

Like any procedure, an angiogram involves use of needles and some poking and prodding, but any type of discomfort is usually minor. You will not feel pain when catheter, a slender 
flexible tube, is inserted into artery. There are no any nerves in the arteries themselves, so you will not feel the catheter moving through your arteries and into your heart. When 
the catheter is in it's position, the cardiologist will inject contrast dye through the catheter into arteries. Most people don't feel the dye injection. However, some may feel minor 
discomfort in their chest, typically lasting only a few seconds. A few people feel lighthead or nauseous. Some people say the most uncomfortable part comes after the angiogram, 
once catheter is removed. To prevent bleeding, a nurse will apply pressure on your leg where the catheter was inserted and hold it around 20 minutes. Then, afterwards a dressing 
is applied, a weight which is often a sandbag weighing about 10 pounds or a clamp may be placed on the wound to help a blood clot form. Instead of putting the weight on the puncture 
wound, some doctors may insert a small device that encourages a blood clot to form.

What complications can happen?

Before the procedure, you need to discuss a wide range of issues with your doctor including, Medical history, whether or not you have asthma, allergies or kidney disease, If 
you have experienced allergic reactions to any drugs or any current medications you are taking. You may need to discontinue certain medications before the test, such as medications 
that thinner blood. You need to fast four to six hours prior to the test. You may undergo a series of tests before angiogram, including blood tests, an electrocardiogram and chest 
x-rays. You may develop an irregular heartbeat from having the catheter within your heart or because of the dye injection. If it happens during your angiogram, your doctor will 
treat straightaway.

Are there any alternatives?

You will need to make another appointment with doctor to discuss the results of angiogram. Treatment depends on diagnosis. Narrowed coronary arteries may possibly be 
treated during angiogram by a technique known as angioplasty. A special catheter is threaded through the blood vessels and into the coronary arteries to remove blockage. 
Another surgical option for severely narrowed coronary arteries is by-pass operation. This involves transplanting veins and arteries from other parts of your body to heart. 
Faulty heart valve seriously requires surgical correction.

How soon will I recover?

Be guided by your doctor, but general suggestions include - Try to rest as much as you can, avoid standing for more than few minutes at a time. Avoid heavy lifting of objects. Meet
your doctor if you suspect infection. Symptoms include redness, heat, swelling and discharge from the wound site. But under proper conditions, these can be avoided.

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